Real immersion versus digital — plus fishing, Twitter, digital overload, and PTSD

Forgive my recent blogopause. i was fishing, and then traveling, and then writing rather head-down intensely — all activities I have trouble mixing with blogging and social media such as Twitter, which I’ve also left idle these last days.
So what gives with all that? I often find it awkward to switch between blogging or twittering and engaging deeply immersive physical activities. This hiatus, for instance, started when I went fishing last Tuesday on Lake Champlain for salmon — a piscatorial retreat before a highly engaging work trip to NY, DC, and environs to talk to scientists and see my bro. That outing was a lovely, brilliant day, not so great for actually catching salmon — the clear light gives them caution, and besides that the water was still in the 40s — but a great day to be on the water.
On my drive to the lake I thought to myself, “I should twitter this!” But once on the water, with the boat quietly rumpling the ripples, and the cork-handled fly rod in one hand and the tiller in the other and my attention keenly on current and every pulse and tremble the cork brought me … the idea of thumbing a touchscreen seemed ludicrous. Two days later, I spent several hours talking with scientists about social relations among monkeys — and the whole twitter business, though I find it useful and at times interesting, seemed a rather odd way to build, manage, maintain, and work really meaningful social relations.
I mean to write more about this later. For now, let me just say that when compared to the close solitary engagement that is fishing or me physically rich gossip of monkeys (as well as the deep immersion in reading and writing I indulged in on return), twitter seems a sin and unnuanced form of gossip and, God forbid, much more promotion than conversation.
I’d better give you something more than that before I go fishing again. Here are a few links I have found useful — in which I might write up if I were not getting ready to go do a bit of field survey of the striped bass on Joppa Flats.
Vaughn beats up the Times and a couple of other places for what he calls data-free whacks at digital overload.
Somehow, post traumatic bitterness disorder — I am not making this up — has escaped either my attention or my memory until now. But apparently it was described in a 2003 paper by one Dr. Michael Linden, a German psychiatrist. I am distressed to see it treated rather matter-of-factly in this blog post by GrrlScientist, who usually shows better instincts. I will get to this one later, I hope. In the meantime, let me just say it brings to mind a story a friend reason he told me about a friend of hers who received a diagnosis of posttraumatic stress disorder because she was struggling… with what to do with her time now that she has retired. That would presumably be a subtype of PTSD: posttraumatic postretirement stress disorder.
In a more sober look at the subject, a new British Journal of psychiatry paper examines delayed-onset PTSD and concludes that “only limited compared all data support the existence of” a delayed onset form of PTSD. As claims for such delayed-onset cases rise at the VA — and seem weirdly limited primarily to war veterans — this is a subject of some import. It adds to data (as described in my Scientific American story) suggesting that many other problems, ailments, troubles, and phenomena in aging vets are being attributed falsely to PTSD.
I’ll be back next week. Till then it’s all clousers, deceivers, stripers, beach, and sun.
Don’t get me all wrong here. It’s not all fishing and monkeys. Right now, for instance, I have to go to the dentist for a filling.

Afternoon dip – Zombie fire ants, stereotype threat, bedtime routines, floating plastic, and tree-climbing bots

Having lived with fire ants, stepped in fire ants, laid down with fire ants, and been bit just about everywhere by fire ants, the news that parasitic flies turn fire ants them into zombies by eating their brains pleases me immensely.

Speaking of pleasure: Vaughn whacks the dopamine = pleasure meme.

Sharon Begley says Obama may get a lot done, but he can’t erase stereotype threat (so far).

We may be dozing, but Europe is ordering its swine flu vaccine. D’oh! Update: We’re getting a start too.

“Good night, sleep tight, I love you.” Why consistent bedtime routines work.

Why the best medical reporters aren’t necessarily doctors.

GOOD makes a pretty map of ugly floating plastic, while Catherine Rampell calls out another nice oceanic map: parked freighters.

Now we’re getting somewhere: A tree-climbing robot.

Revere puts up a fascinating post pondering whether there’s something unusual about the swine-flu symptoms and considers why older people seem to be less at risk.

Rotten fridge cleanup sends 7 to hospital. Really.

Pharma objects to empiricism, part xxx

What’s wrong — but horribly expected — in this picture? One week the CEO of Lilly attacks the idea of a public health insurance plan because it might reduce consumers’ “ability to choose, in an informed way, from all the available alternatives.” The next week, PhRMA, the trade group this CEO’s company is a part of, launches a campaign to undermine comparative effectiveness studies — which would produce the data necessary for informed consumer choice.

If that’s not enough, this campaign against collecting actual empirical effectiveness data, spearheaded under the astroturf group Partnership to Improve Patient Care (headed by former Rep. Tony Coelho), uses the same logic: Comparative effectiveness data, by giving us more and better information, would somehow make it harder for docs and patients to make informed decisions.

This gets at the deep problem created by allowing pharma to dominate drug-testing with clinical-trial data while we lack any real ability to collect information on how well various drug and other treatments actually work in clinical practice. It takes decades to see how well these drugs really work. Pharma may test and promote a new generation of miracle antipsychotics and antidepressants in the 1980s, and it’s 20 years later we finally have enough meta-analyses of actual clinical use to see they work no better than the drugs they replaced. In the meantime, these drugs have cost us 20 times as much. We’re running largely blind — and must rely on data generated by studies that are designed at the start to get good results, and which are then interpreted and filtered to exaggerate benefits and downplay or outright hide risks (like death and such).

This isn’t an ideological issue — unless you want to call the idea of medicine as an empirical science an ideology. It’s not just a  cost issue — though cost is important, as we’re spending far more than other countries and getting worse outcomes. Cost (a word used with disdain by outfits like this new one formed by pharma, as if cost is the concern only of cynics, cheapskates, and those who don’t “value” human life) is just one concern being addressed by the comparative effectiveness drive, and it’s a legitimate concern, because money spent on mediocre or lousy treatments is money we can’t use to treat the vast unwashed and uninsured.

So yes, costs are a goal. But the true goal of the comparative effectiveness movement is not cost but effectiveness, and the creation of a huge database that will show what works and what does not. That’s not social engineering or socialized medicine. That’s empiricism — and a much truer “consumer” (i.e., patient) empowerment.

I’m all for good, effective drugs. I owe my life and that of most of my family to them. But the damage done by pharma’s worst excesses to the name of medicine — and the cause and definition of medicine as an empirical endeavor — is incalculable. The industry clearly recognizes that comparative effectiveness data — a true measure of what works and what doesn’t — will threaten the tremendous profits it has made from drugs that improve little if at all on existing treatments or no treatment. The industry’s only hope to hang on to those profits is to continue to dominate the information stream on what appears to work and what doesn’t. As it stands now, they’re getting a good decade or so with each generation of drugs — longer than a patent run — before enough clinical information accumulates to really evaluate them. The comparative effectiveness movement threatens to shorten that window.

Curveball deception & Koufax as god, cont’d

Nov 27, 2010: Argh. The footage I’d found has been pulled from YouTube. Not sure why, though MLB keeps a tight leash on such things.
Found some Koufax footage. About halfway through this short clip he Ks Mantle, looking, and a bit later, in the dark footage toward the end, is a good strip of him throwing the devastating curve. Note there the emphatic downward motion of his shoulder — which brought down his hand the faster, which (along with big, flexible hands and fingers) helped him make the ball spin 15 times on the way to the plate instead of the MLB-standard 12-13.

Following up my curveball coverage of last week, faithful reader and Cognitive Daily maestro Dave Munger wrote in noting that Arthur Shapiro, one of the authors of the curveball-explaining Illusion of the Year (and a friend of Munger’s) posted a fuller explanation of the illusion and effect at his website, Illusion Sciences. As in the prior post, I’m not putting the illusion here because a) that way you’ll have to see it there and b) I don’t know how to move the illusion here anyway; I try, and my eyes hurt (a visual illusionist’s DRM, I suspect). But I past in here an elided version of Shapiro’s the fuller explanation. I love the dryness of the first couple sentences.

NB: Koufax-as-god bonuses for those who read (or skip) to the end of Shapiro’s excerpt.

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POWs who weren’t, cont’d

A few weeks ago, when I posted that “Uh-oh: POW benefit claimants exceed recorded POWs, one reader wrote saying the post made her wonder whether I have “a problem with veterans.” As one reader noted, a concern with bogus POWs suggests I have a problem with — well, bogus POWs. Should it not bother us when people masquerading as POWs are collecting benefits and kudos and sympathies they didn’t earn — and which others earned through rather excruciating means?
Now it’s bothered a couple members of Congress who served in the military, as the press release from Rep. Mike Coffman, R-CO, describes.

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Human Descent from Lemurs? Could be, sortalike


A ring-tailed lemur, via Afarensis

Here’s one that’ll grab you. Via Discover’s 80beats science news blog:

A small, lemur-like creature may have been an early ancestor of monkeys, apes, and humans. A magnificently preserved fossil dating from 47 million years ago reveals an animal that had, among other things, opposable thumbs, similar to humans’, and unlike those found on other modern mammals. It has fingernails instead of claws. And scientists say they believe there is evidence it was able to walk on its hind legs [ABC News].

This from a study to be published in PLoS ONE tomorrow, and which will note that this fossil could be from a “stem group” from which higher primates evolved — though the researchers reportedly told the Times that “we are not advocating this.”
There’s a great backstory:

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Deficit I mean Health Care Reform: Eye-popping chart dept.

via Ezra Klein comes this bottom-line chart from the Center for Economic and Policy Research:

That orange line headed heaven-ward? That’s our deficit. All those other lines dipping down? That’s our deficit if we had the same health care spending per person as France, Germany, Canada, and the UK (all countries, incidentally, with higher life expectancies than our own). You might say, of course, that even radical reform would not bring us down to their health care spending. We could copy France’s system wholesale and still pay more for care. You would be right. But such reforms would bring us much closer than we are now.

This is a nice turn, for it gets at perhaps a more important point more directly than does even Peter Orszag’s scary graph about health-care spending as a percentage of GDP. And as Klein notes, this graph clearly doesn’t mean we can automatically reap all savings these other countries generate by adopting their systems wholesale. But to emulate the key parts would definitely save money — and to not do so is to further compromise our competitiveness (and lower our quality of life by spending an increasing part of income on inferior health care).
Klein presents the graph as part of rebuttal to some material lately from the (rightly admired) Tyler Cohen. It’s a good rich dialogue going there. Get the whole thing at Ezra’s new blog at Washington Post.

The power of conformity: Candid Camera elevator psychology

Most of us recognize the power of the urge to conform , but you don’t often see it evoked and displayed so starkly as in this old Candid Camera segment. The CC crew seeds an elevator with several crew members who do odd things like face the rear of the elevator car. See how long the naive bystanders who join them hold out against the pressure.
— Whu-oh: This is where missing video was —
update: Posted here was a wonderful segment as described above. I had found it via Google Video. It was up about 3 hours when I got an email from someone claiming to be from Candid Camera, Inc., asking me to take it down as it was not licensed and I was violating copyright. They asked very politely. I complied.
But I keep having this feeling that I was part of a Candid Camera (Candid Interwebs?) experiment myself.

An optimistic take on health-care reform

Ezra Klein thinks the stars — and the forces — are so far lining up much more promisingly than in 1994:

The opponents of health reform are, at this juncture, entirely isolated. Industry is adopting an attitude of relentless positivity. Republicans are grudgingly attempting to appear cooperative. The only straight opposition is coming, as Maddow and Howard Dean say, from Rick Scott, a disgraced former hospital executive whose company was convicted of defrauding the federal government in the largest ever case of its kind.
You can say, of course, that the traditional opponents of reform will rapidly find their voice when the bill emerges. But they’re lagging. The difference between this year and 1994 is that in 1994, it was the opponents of reform who spent the preceding year massing their forces and organizing their grassroots. This year, it’s Health Care for America Now and SEIU and and Obama for America who have spent the last 12 months building out their organizational capabilities. The campaign on behalf of reform, in other words, is significantly farther along than the campaign against reform.

Effect Measure on what “so far, so good” means

I should just have a permanent pointer from here to Effect Measure. But as I’ve not figured out how to do that, here’s some more sensible thinking from Revere:

No one on the public health side has over reacted. When an outbreak or pandemic is unfolding, you get only one chance. The window is a narrow one. CDC (and WHO) have acquitted themselves well, so far. CDC’s daily briefings have been straightforward and informative. The public, understandably, has bounced back and forth from fear to relief and back again. I don’t think either pole is avoidable. If the scientists are baffled and uncertain, the public has a right to be, too. But CDC has been steady and consistent in their approach (more so than HHS or Homeland Security, in my view) and they clearly understand the most important thing: this outbreak is still evolving and it is premature to write it off.
The idea this is “mild” flu virus is so far true, but mild is a relative term, as we have pointed out here. And “so far” is another important qualifier. This virus is spreading relatively quickly, but it isn’t everywhere and not much time has passed. With exceedingly virulent strains like the 1918 virus many people died relatively quickly but with flu death usually comes weeks after the onset of infection. Not that many people have been infected as yet. If the pace of new cases accelerates, we will likely seem many more hospitalizations (currently there are only 35 in the US) and more deaths (currently there are two)

Here’s the analogy struck me a minute ago while I was brewing coffee:
You’re approaching an intersection. You see a big truck on the intersecting road is fixing to run the stop sign and smash you. You slam on the brakes — only to find the truck has slammed on its brakes and doesn’t enter the intersection. You release the brakes and roll through unharmed.
Have you overreacted?
Get it all at Effect Measure.